Pediatric Orthopedic Surgeons treating Extra Fingers and Toes

POLYDACTYLY EXTRA FINGERS AND TOES

The medical term for having an extra finger or toe is polydactyly (pol-ee-dak-tuh-lee). The term literally means “extra digit.” Usually, a child has the extra digit next to the thumb, big toe, little finger or little toe.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Polydactyly Extra Fingers and Toes

Extra FingersPolydactyly is the medical word for having extra fingers or toes. Additionally, it could be referred to as hyperdactyly. The hands and feet of newborns are one of the most typical birth abnormalities. One type of congenital hand variation is polydactyly, which results in additional fingers growing on your child’s hand. Your healthcare professional will use an ultrasound before delivery or a physical examination soon after birth to determine whether your baby has polydactyly. The location of your child’s additional digits will determine how it is handled.

Polydactyly types:

Depending on which fingers or toes your kid has extra, your doctor will categorize the polydactyly they are born with. Polydactyly can take the following forms:

Preaxial (radial/tibial) polydactyly

An extra large toe or thumb.

Central polydactyly

A fourth finger or toe between the middle digits’ index, middle, and ring fingers, or any toe other than the big or pinkie toe.

Postaxial (ulnar/fibular) polydactyly:

An additional pinky finger or toe

Causes of Extra Fingers and Toes

When a kid is growing within the womb, polydactyly begins to form. The fingers and toes of the hands and feet initially resemble flat, paddle-like extremities until approximately week six of pregnancy, when this process begins. In certain instances, a digit will divide into two pieces rather than producing a single finger or toe. While it doesn’t necessarily run in families, polydactyly can. Polydactyly frequently develops spontaneously, without a hereditary reason. Other than the additional digit, the youngster won’t experience any developmental delays. However, polydactyly can also be a sign of other underlying disorders. These ailments include Bardet-Biedl syndrome, Pallister-Hall syndrome, and McKusick-Kaufman syndrome. You can discuss the cause with your doctor if your kid has further physical or developmental issues. To look for other health issues in your kid, you might require additional testing.

QUESTIONS AND ANSWERS

What causes polydactyly, and is it a genetic condition?

Polydactyly can have a genetic component, meaning it may run in families. However, it can also occur sporadically without a clear genetic cause. Genetic factors, environmental influences, or a combination of both may contribute to the development of polydactyly. The doctor will likely discuss the family history and may recommend genetic testing to determine if there is a hereditary component.

How will polydactyly affect my child's development, and what treatment options are available?

The impact of polydactyly on a child’s development can vary depending on the specific nature of the condition. In many cases, polydactyly does not cause functional problems, and the extra digit may be fully functional or rudimentary. Treatment options depend on factors such as the location, size, and functionality of the extra digit. Surgical intervention may be considered to remove or reconstruct the extra digit, typically performed in early childhood. The decision for surgery is often based on the individual circumstances of the child and the family’s preferences.

Will my child lead a normal, healthy life with polydactyly, and are there any long-term concerns?

In most cases, children with polydactyly can lead normal, healthy lives after appropriate treatment. The prognosis largely depends on the severity of the condition and the success of any surgical interventions. After surgery, the child may undergo a period of rehabilitation and follow-up appointments to monitor their progress. Long-term concerns are generally minimal, especially if the extra digit is successfully addressed during early childhood. The doctor will provide guidance on postoperative care, any necessary precautions, and what to expect in the years following treatment.

It’s important for parents to have open and honest discussions with their child’s healthcare provider, who can provide detailed information about the specific type of polydactyly, potential treatment options, and the expected outcomes. The doctor will work with the family to develop a personalized plan that addresses the child’s unique needs and circumstances.

The doctors and surgeons are well aware of congenital medical conditions being caused by certain gene mutations.  Having more than 5 fingers or toes is an example of mutations of certain genes.  We only treat children and can properly treat children with extra fingers and toes.

Symptoms

A person with polydactyly is born with additional fingers or toes on either one or both of their hands or feet. Polydactyly can manifest in a variety of ways. There might be a:

  • A tiny, elevated mass of soft tissue without any bones (called a nubbin).
  • Incompletely developed finger or toe with some bones but no joints.
  • A finger or toe with tissues, bones, and joints that is completely functional.

Diagnosis

Using an ultrasound before birth or after birth, your healthcare professional will determine if your baby has polydactyly. They will determine whether your child has any additional fingers or toes and will make a polydactyly diagnosis. Before beginning treatment for the polydactyly, your baby’s hand or foot may require an X-ray.

Genetic testing for polydactyly:

Genetic counseling can assist you in determining whether or not genetic testing is necessary for you if you have a family history of a genetic condition. Including the genetic alterations that result in polydactyly, this can check for any problems. Many times, having mutations does not always predispose your offspring to a genetic illness. Hereditary counselors can explain your risk and advise you on any precautions you can take to preserve your health or reduce the likelihood that you will pass certain genetic conditions on to your offspring.

Treatment for Extra Fingers and Toes

If you have a family history of genetic abnormalities, especially if any of your close relatives (such as your biological grandparents, parents, or siblings) were born with extra fingers or toes, your kid may be more likely to experience it. It’s not a given that your child will have developmental issues or any other conditions just because they were born with extra digits. Treatment for polydactyly depends on how and where the extra fingers connect to the hand or foot. In most cases, the extra digits are removed by the child’s first two years of age.

This allows the child to use their hands normally and to fit their feet into their shoes. Most of the time, polydactyly may have little to no impact on your child’s physical development. It’s not harmful to have an additional finger or toe. Your baby won’t experience any symptoms or pain as a result of the additional digits. Adults may have surgery to enhance the appearance or functionality of their hands or foot. Surgery is often performed as an outpatient procedure under local or topical anesthetic. Research on various surgical procedures is still going on.

Fifth Digit

The removal of an additional little finger or toe generally only requires minor surgery. Stitches will be used to seal the wound on the youngster. Within two to four weeks, the sutures fall out.

Thumb or Big Toe

Removal of an extra thumb might be difficult. To be useful, the remaining thumb needs to be at the ideal angle and form. This might need some transformation of the thumb, involving the soft tissues, tendons, joints, and ligaments.

Central Fingers or Toes

This type of surgery is typically more difficult and necessitates hand reconstruction to guarantee full functionality. It might need more than one surgery, and the kid may need to wear a cast for a few months after the surgical treatment. To lessen scarring and enhance function, the doctor could advise physical therapy. When your child is between the ages of one and two, your doctor will often suggest polydactyly surgery to remove additional fingers or toes. Surgery aims to provide your kid with hands and feet that both appear and behave appropriately. Doing surgical treatment while your kid is still young helps in making sure that they don’t miss any milestones associated with using their hands or feet.

Complex Surgical Method

In order to minimize complications during subsequent growing, the additional digits are typically surgically removed in early childhood (baby phases). This technique aims to offer hands and/or feet that seem and behave normally. Practically speaking, eliminating the additional digits will make the child’s foot fit comfortably inside his shoes. Based on the digit’s complexity—i.e., the presence of bone, blood vessels, and nerve—this strategy is employed. Each case’s intricacy is assessed using X-ray technology.

Simple Surgical Method

The doctor will check your child to see if the additional digits have a joint or bone. For more information on how the extra digit is attached, they might need to obtain an X-ray. That will assist your doctor in determining the type of operation that is required. This could encompass:

Vascular clip:

The doctor will tie off the additional digit’s base if it lacks a bone. As a result, the additional skin will lose its ability to receive blood and perish. It is comparable to how a baby’s umbilical stump disappears after delivery.

Surgery for Extra Fingers and Toes

Your doctor will need to perform surgery if there is a bone or ligament in the additional digits. Without having to rebuild any of your child’s hands or feet, the doctor may usually remove the additional digit in simple circumstances. The hand or foot will need to recover while your child is wearing a splint or cast.

Surgery with reconstruction:

The procedure could be more difficult if the additional digit’s bone or ligament impacts how the remainder of the hand or foot functions. To ensure that the hand or foot operates properly, the doctor will gently remove the additional digit and reroute any compromised bones, tendons, or ligaments. After a complicated operation, your kid could require physical or occupational therapy to strengthen their hand or foot. Your kid may need to undergo physical or occupational therapy after surgery to help with scars, stiffness, and swelling. Your child may also need to wear a bulky bandage or cast for a few weeks. They could go for follow-up appointments to see how their hand is recovering and functioning.

Some kids only require one treatment to remove an extra digit, while others may later require multiple surgeries to improve the function of their hand or foot. Your doctor will discuss with you what will aid your child’s recovery and any potential future operations with you. The biological building elements passed from parents to babies are called genes. They provide instructions for each cell in your body’s development and operation. Your baby’s body may alter if anything disrupts or modifies a gene while they are still developing.

Sometimes these alterations go unnoticed, while other times they lead to problems like polydactyly and other congenital disorders. There’s a possibility that your unborn child will have polydactyly if anything has an impact on the genes in charge of growing their hands, feet, and limbs. Environmental factors as well as genetic abnormalities can affect these genes (things that happen to or around a pregnant person).

Complications and Outlook for Children with Extra Fingers and Toes

Most polydactyly patients who get treatment regain complete hand functionality and an enhanced hand look. It could be necessary to monitor your child for months or even years in order to:

  • Check to see if their hand is recovering properly.
  • Verify that their hand has recovered its full functionality.
  • As your child develops, consider if future surgery might enhance the hand’s beauty or functionality even more.

The condition of polydactyly is quite normal. It has been preserved through the ages and is shown in prehistoric art that dates back over 10,000 years. The doctor treating the kid may keep an eye on how the affected hand or foot is working. Adults may also have surgery to enhance the hand’s or foot’s beauty or functioning. Other body parts may suffer from the effects of syndromic polydactyly. The future will rely on the underlying condition because it may potentially entail delayed development and cognitive dysfunction.

How do you Find the Right Doctor to Treat your Child with Extra Fingers or Toes?

Parents of children with extra fingers or toes should bring their kids to Medical City Children’s Orthopedics and Spine Specialists because:

  • Specialized expertise: Medical City Children’s Orthopedics and Spine Specialists has a team of highly skilled, experienced pediatric orthopedic surgeons and spine specialists. The doctors and surgeons specialize in treating children with extra fingers or toes.
  • Comprehensive care: Medical City Children’s Orthopedics and Spine Specialists offers a full range of diagnostic and treatment options for extra fingers or toes.  These include advanced imaging technologies, physical therapy, bracing, and surgical interventions.
  • Family-centered care: Medical City Children’s Orthopedics and Spine Specialists takes a family-centered approach to care.  Our doctors work closely with parents and caregivers to develop individualized treatment plans for each child’s unique needs and goals.
  • Support services: Medical City Children’s Orthopedics and Spine Specialists offers a variety of support services for families.  These include social work, child life specialists, and patient and family education resources.
  • State-of-the-art facilities: Medical City Children’s Orthopedics and Spine Specialists is part of a leading medical center with state-of-the-art facilities.  Doctors and surgeons have the latest technologies to support the diagnosis and treatment of extra fingers or toes.

Overall, Medical City Children’s Orthopedics and Spine Specialists with offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX offers comprehensive and specialized care for children with extra fingers or toes, with a focus on improving outcomes and quality of life for patients and their families

____________________

Footnote:

National Institute of Health: Polydactyl

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at five convenient locations: Arlington, Dallas, Frisco and McKinney.